Citation: Memtsa M, Goodhart V, Ambler G, Brocklehurst P, Keeney E, Silverio SA, et al. Wherever possible, all data relating to hospital admissions provided by the IS departments were crosschecked by a member of the research team against ward admission books/databases in an attempt to check their accuracy. We value all people andstrive to beopen, honest and accountable for the care provided. There are strong links with the Institute of Reproductive and Developmental Biology (IRDB) at Imperial College London run by Professor Phillip Bennett, with projects ranging from the study of the microbiome to novel biomarkers in early pregnancy. As a secondary outcome, we aimed to establish the number of emergency hospital admissions for women attending EDs in the same location as the EPAU for first trimester pregnancy complications. Equally, weekend opening of an EPAU, even for a limited number of hours, is associated with lower probability of emergency hospital admissions. The Early Pregnancy Unit runs in parallel with the Gynaecology Assessment Unit (GAU) and provides services for women with complications of pregnancy such as pain or bleeding up to 16+6 weeks gestation. There is a dark mat or floor marking at this entrance that might be perceived as a hole. Continuing will take you away from the (2021) Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and weekend opening on emergency hospital admissions: Findings from the VESPA Study. Yes, however bleeding does not necessarily mean there is a problem. Mobility aids are available to help patients move around and include; wheelchairs and crutches. The car park does have a height restriction barrier. Volunteers do not receive disability awareness / equality training. Fitting hierarchical logistic regression models for Emergency admission from EPAU, there was little evidence of an association between the admission rate and planned senior clinician presence or unit volume controlled for final diagnosis and maternal age, as shown in Table 5. If you feel your symptoms require urgent assessment outside of these hours the wider medical team are here to support you 24 hours a day 7 days a week. Tommys Tommy's is a charity that funds research for pregnancy and babies. Data curation, If the outcome of your consultation is that you require an ultrasound then our ultrasound scanning appointment times are from 9:30am 4.00pm on weekdays. The telephone number for the Patient Advice and Liaison Service (PALS) is 020 3447 3042. In view of this, we revised our cut-off and used 2500 instead of 3000 visits to describe the units as high or low volume in the final data analysis. The contrast between the wall-mounted grab rails to the left of the toilet and wall is poor. The contrast between the internal door and wall is good. You will have a telephone assessment with a specialist EPAU nurse, and they will advise whether you need to attend a booked appointment for a face-to-face assessment and/orscan. Referrals are either from GP or the emergency department. We have placed cookies on your computer to help make this website better. Investigation, Scans appointments are every weekday morning and afternoon. We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. Validation, MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. We are able to offer electives for medical students. Travel information is subject to change. There is not a door release button when exiting. Methodology, These data were collected retrospectively at the end of the three-month period corresponding to the date when the last woman recruited to the cohort study was discharged from each hospitals EPAU. Yell.com Yell Business. There is room for a wheelchair user to manoeuvre. Discover a faster, simpler path to publishing in a high-quality journal. The Early Pregnancy Assessment Unit (EPAU) provides care and support to women and anyone experiencing complications in early pregnancy, as well as their partners. You should still contact the Early Pregnancy Unit on the phone number below, which will inform you of where to call in the event of an emergency. We care for women with acute early pregnancy problems and acute gynaecology issues. The contrast between the dropdown rail(s) and wall is fair. Resources, Contact us. Forfurther advice aboutemergency gynaecology at Barnet Hospital, call020 8216 5233. Introduction Pregnancy can be a turbulent time, both physically and emotionally, for women and their partners. Data curation, There are coat hooks in the toilet at 107cm and 147cm from the floor. Early Pregnancy Unit and Gynae Assessment Unit. The closest station is Southampton Central which is approximately 2.3 miles from the Hospital. The main door(s) open(s) automatically (away from you). When describing your problem or suggestion, Our findings are in contrast with the results of previous studies in other clinical settings, which showed that involvement of more experienced clinicians in delivering emergency care results in a significant reduction in emergency hospital admissions and the length of stay in hospital [12, 18]. There is dedicated team of trained sonographers and consultants who provide the ultrasound services. Mirrors are not placed at a lower level or at an angle for ease of use. The height of the bell/buzzer is 134cm (4ft 5in). Writing original draft, There is not a play area or toys/books for a child to play with. e0260534. The dimensions of the lift are 176cm x 270cm (5ft 9in x 8ft 10in). Supervision, The contrast between the walls and floor is good. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. There is a vertical wall-mounted grab rail on the transfer side. However, our study is the first large prospective study designed with a specific aim to study emergency admission rates in women presenting with acute first trimester pregnancy complications. You might find it helpful to talk to your GP, midwife or early pregnancy staff if you are feeling anxious. For more information about PLOS Subject Areas, click This showed substantial variations in the proportion of in-patient emergency admissions with 8.5% in units without, and 3.5% in those with, senior clinician presence. We have links to excellent onsite gynaecological oncology and endometriosis services across sites. To obtain mobility aids please contact the main reception. The VESPA study recruited from the EPAU population. Visualization, The door(s) open(s) away from you (push). There is a dropped kerb from the drop-off point. There is a low section of the desk (76cm or below) available. If required emergency surgery can be performed, or women may be monitored and appropriate follow up arrangements made. Access to the hospital is either by following the pedestrian marked path around the hospital building or via a very narrow spiral staircase. Methodology, There are also several bus routes which stop at the Southampton General which is a short walk from the Princess Anne Hospital on Tremona Road. Get contact details, videos, photos, opening times and map directions. The car park surface is a shared surface. EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. Warren Street (Northern / Victoria Lines) and Euston Square (Circle / Hammersmith & City / Metropolitan Lines) are the closest tube stations to University College Hospital (UCH). The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. The Early Pregnancy Assessment Unit (EPAU) in Ward C1 at the University Hospital of Wales is an integrated single unit, which takes referrals from all overCardiffand the Vale of Glamorgan. There is sufficient space for a wheelchair user to manoeuvre within the imaging room. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . The majority of units (37/44) had a unit volume of less than 4000 visits per year, and 22 units had a yearly visit volume lower than 2500 visits per year. 6606 pregnant women (16 years old) with suspected first trimester pregnancy complications attending the participating EPAUs or Emergency Departments (ED) from December 2016 to July 2017. The barrier controls/touchscreen can be reached from the car. Assistance may be required because there is/are uneven surfaces. Five working days should be allowed by patients/carers to receive their dispensation notice in the post, to allow time for the request to be processed and received in by second class post. Funding acquisition, The nearest designated Blue Badge parking bay is approximately 25m (27yd 1ft) from the Elizabeth Garrett Anderson Wing main entrance. The lift does have a visual floor indicator. Our study has several limitations. d) previous tubal surgery Traffic light controlled pedestrian crossing points are located adjacent to each tube station. The Early Pregnancy Assessment Unit (EPAU) is a nurse-run, consultant-led unit located at Junction 5 within the York Teaching Hospital. The unit is open Monday to Friday from 8am-6pm and Sunday 9am-5pm (closed on Saturday). Euston Road - no's 18, 27, 30, 88. 023 8077 7222. If it is decided that you need outpatient care,the Emergency Department will send an electronic referral to the EPAU nurse, and you will be contacted either the same dayor the next working day. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. Conceptualization, Writing review & editing, Roles Try to follow the advice about drinking little and often to avoid this as much as you can. There is a canopy or recess which provides weather protection at this entrance. All rights reserved. No, Is the Subject Area "Pregnancy complications" applicable to this article? There is not a 120cm hatched zone around the Blue Badge parking bay(s). Standard manual wheelchairs are available for people to borrow at this entrance. The post code for the Sat-nav is SO16 5YA. Writing original draft. The Blue Badge bay(s) is/are clearly marked. Peter Brocklehurst reports grants and personal fees from MRC, grants from MRC, NIHR HS&DR, NIHR HJTA, Wellcome Trust, personal fees from AG Biotest, outside the submitted work. You will then have an ultrasound scan which is usually a transvaginal scan (internal scan), to assess your pregnancy. There is step free access to Early Pregnancy Unit and Gynae Assessment Unit. Yes We recommend upgrading your browser to continue. The width of the door opening is 88cm (2ft 11in). A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. Is the Subject Area "Pregnancy" applicable to this article? Methodology, IMD scores were divided into 10 decile groups. Initially, we investigated the association between senior clinician presence, unit volume, and weekend opening hours on emergency admissions from EPAU. Possible symptoms include: Bleeding On entering via the Level D entrance continue ahead and the entrance to the Early Pregnancy Unit and Gynae Assessment Unit department is on the right. The dispensation notice is a Camden Councils parking scheme for Blue Badge holders who are attending outpatients appointments at University College London Hospitals NHS Foundation Trust (UCLH). When you attend an early pregnancy appointment you can bring one adult support partner with you however no children are currently able to attend with you. On arrivalyou will be booked in by our dedicated admin clerk anddirected to the EPAU waiting area with your referral form and a number. The wash basin and tap(s) can be reached from seated on the toilet. This accessible toilet is located along the department corridor. The relationship between emergency admissions from the Emergency Department and senior clinicians presence in EPAU is shown in Fig 4. https://doi.org/10.1371/journal.pone.0260534.g004. The Blue Badge bay(s) is/are signposted but have no markings. Early Pregnancy Assessment Units are highly valued by women but aspects of their care experiences, particularly around sensitive management of pregnancy loss, could be improved. The median admission rate among 44 units was 2.8% (range 0% to 13.7%) (Fig 1). Project administration, f) Intrauterine Contraceptive Device in-situ. Funding acquisition, Walk-in centres can be accessed by anyone and have more flexible opening hours. Project administration, Copyright 2023 Imperial College Healthcare NHS Trust, Early pregnancy and acute gynaecology units, Assessment of women with bleeding and/or pain in early pregnancy, Diagnosis and subsequent management of miscarriage and ectopic pregnancy, Nausea and vomiting in pregnancy (hyperemesis), Gynaecology: scans for suspected pelvic pathology requiring emergency review, Possible ovarian cyst accidents (ovarian cyst rupture or torsion), Significant heavy menstrual bleeding with anaemia requiring hospital admission, Expectant, medical and surgical management of miscarriage, Management of ectopic pregnancy: medical, surgical and close monitoring with expectant management, Inpatient and outpatient management of nausea and vomiting in pregnancy, Surgical management of molar pregnancy and liaison with the, Incision and drainage of Bartholins cysts and abscesses under local anaesthesia or general anaesthesia. The funder provided support in the form of salaries for authors MM, VG, GA, PB, EK, SS, ZA, JR, NK, JH, GB, JS, DJ; however, the funder and sponsors of the study did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Ultrasound based assessment for suspected pelvic pathology. The clinic is open from 08.30 to 11.00 Monday to Saturday. About the EPAU The Early Pregnancy Assessment Unit (EPAU) is a nurse-led service which provides specialist care for women who have, or who have had the following: Vaginal bleeding and/or pain in early pregnancy up to 16 weeks Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. During patient recruitment, we collected data on the grade of all members of staff present in the EPAU during its opening hours, their involvement in delivering early pregnancy care, as well as the actual hours which each member of staff spent in the unit. The reception area/desk is clearly visible from the entrance. There is a changing place located on level C of the Centre Block at the Southampton General Hospital. Formal analysis, The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks. Formal analysis, Tel: 01793 605257 . The door does not have a horizontal grab rail. Blue Badge parking bays cannot be booked in advance. The Early Pregnancy Unit (EPU) provides a wide range of services for women who are experiencing concerns in early pregnancy. Call our hospital switchboard on 0118 322 5111 and ask for the On-call Gynae bleep 602. Competing interests: I have read the journals policy and the authors of this manuscript have the following competing interests: MM, VG, GA, ZA, NK, JH, GB, RBA, JS, DJ has nothing to disclose. Monday to Sunday 08:00 to 13:00. The contrast between the toilet roll holder and the wall is good. The main object of the service is to minimise unnecessary hospital admissions, which benefits both patients and the staff. Walk-in Centres There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. There is level access to the consultation / treatment room. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. Writing review & editing, Affiliation Patients can call 0203 447 3013 to request a dispensation notice in advance. Supervision, There is a space for a wheelchair user to wait within the seating area. Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. Data curation, There are not separate entry and exit doors in the lift. The total number of opening hours per weekend was used to illustrate weekend opening. The ramp/slope is located in front of the entrance. The car park is located on Level C of the hospital building. Visit website. All rights reserved. The room does not have background music playing. There is sufficient space to write or sign documents on the desk. Yes The unit characteristics were confirmed again immediately prior to commencing patient recruitment. The study ran from December 2016 to July 2017. The VESPA study received a favourable ethical opinion from the North West Research Ethics Committee (REC reference 16/NW/0587) in the UK, registration number ISRCTN 10728897. We use cookies on this site to enhance your user experience, Getting To The Hospital (Princess Anne Hospital), Getting Help and Assistance (Princess Anne Hospital), Hospital Parking (Yellow Car Park - Level C - Accessible and Parent and Child Parking Only), Hospital Parking (Yellow Car Park - Open Air Parking), Hospital Parking (Yellow Car Park - Level B - Standard and Parent and Child Parking), Getting To (Early Pregnancy Unit and Gynae Assessment Unit), Outside Access (Level D and Out of Hours Entrance), Opening Times (Early Pregnancy Unit and Gynae Assessment Unit), Department / Service (Early Pregnancy Unit and Gynae Assessment Unit), To view the web page described above click here (opens in new tab), Princess Anne Hospital link (new tab) - click here, Hospital Parking at Princess Anne Hospital link (new tab) - click here. Gynaecology Outpatient Department,Ground floor, Green Zone, Lewisham High Road, SE13, Gynaecology Outpatients Department, Stadium Road, Greenwich, London SE18 4QH. There is some flooring in corridors which is shiny and could cause issues with glare or look slippery to some people. However, there was evidence of an association between the emergency admission rate and weekend opening hours. To obtain mobility aids please contact a member of staff. Opening Hours for patient assessment and care planning. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. There is a Patient Advice and Liaison Service (PALS) at the hospital. Access to the waiting area is unobstructed. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Turn right onto Beaumont Place before reaching Warren Street tube station. Conceptualization, The EPAGU at Queen Charlottes is well-known globally for its research output. The dimensions of the accessible toilet are 210cm x 220cm (6ft 11in x 7ft 3in). The bollard(s) has/have a good colour contrast to prevent them being hazardous to visually impaired people. Bleeding and pain during early pregnancy are relatively common symptoms and do not always mean there is a problem. Do you want to change or cancel an appointment?
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